Provider Demographics
NPI:1720732696
Name:ORT, EVA (SLP)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:
Last Name:ORT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 DOLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2734
Mailing Address - Country:US
Mailing Address - Phone:732-598-3502
Mailing Address - Fax:
Practice Address - Street 1:109 DOLINGTON RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-2734
Practice Address - Country:US
Practice Address - Phone:732-598-3502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010258235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18780OtherFLORIDA DEPARTMENT OF HEALTH
NJ41YS00604900OtherNJ DIVISION OF CONSUMER AFFAIRS